San Francisco is generous, good-hearted and socially conscious. It is eager to help the disadvantaged and the poor.

There's just one flaw in our civic personality.

Tough choices.

We'd rather not make them.

On Monday, a parade of hundreds of service organizations appeared before the Board of Supervisors, pleading for funding for their programs. These aren't bad people and their programs to help the young, the drug-ravaged, and the homeless are well-intentioned.

But the hard truth is there are far too many service providers for this relatively small city. They duplicate efforts, they don't have enough oversight, and they spend hundreds of millions of city dollars.

Now - and here's the tough part - with the city facing a historic $483 million deficit, some of them are going to have to go. Or, as the San Francisco Community-Based Organizations Task Force put it in April 2009, they need to be "encouraged to identify their placement within the nonprofit life cycle, and contemplate the possibility of closure."

Close service organizations? Let the howls of protest begin. But let's take a hard-eyed look at this.

The city contracts with nearly 500 service organizations, spending roughly $500 million a year. In March 2009, the controller's office presented a report that showed the city and county of San Francisco outspends Los Angeles County by a per capita 8-to-1 on substance abuse, provides three times the per capita amount of funding of San Mateo County on mental health, and subsidizes child and maternal health 31-to-1 compared to Sacramento County.

So it isn't as if we are not addressing the problems. But every report, from the controller's office, the Organizations Task Force, to the civil grand jury report on homelessness, comes up with the same conclusion - there needs to be a way to determine which groups are effective.

"We are the broker of service, we need to be responsible for the public dollars," said Barbara Garcia, deputy director of health. "The city is going to have to have a statement of accountability."

The motivation may be the budget deficit, but this is discussion that is long overdue. Holding nonprofits to measurable standards, and taking a hard look to see if they are duplicating efforts, is essential.

"It's a hard conversation, but this is the right time to have it," said Maria Su, director of the Department of Children, Youth, and Families, which controls a budget of $82 million. "My sense is that we fund a lot of boutique programs. And I don't believe our children are that boutique-y."

DCYF is among the city departments that is requiring accountability benchmarks. It wants to see solid financial records, time cards and solid goals. And, like the Department of Public Health, they are going to demand that nonprofits get out and earn extra funding beyond what they get from the city.

"Some of these organizations have been totally dependent on city dollars for 20 years," said Garcia, who used to work with a nonprofit focusing on migrant farmworkers. "I don't care if they have to charge clients $5 for services."

Tough talk, but let's see what happens. Two years ago, Trent Rhorer, director of the Human Services Agency, went to the supervisors with a proposal to cut funding for a group home for foster kids. Rhorer had up-to-date studies and data that showed that foster children did much better in individual homes. A large proportion of group home residents ended up in prison.

The reaction was swift and harsh. Rhorer was lambasted and vilified, and the program was funded. Today, even supporters of the home admit Rhorer had a point.

But to cut the funding would have meant stepping up and making a tough, unpopular call. Nobody does that here unless they have to. Now they have to.